Hari on artemisinin resistance

Johann Hari on the alarming development of artemisinin resistance

But then something began to change – at first imperceptibly – in the forgotten forests of Western Cambodia, where the Khmer Rouge held their last stand-off. The drug that is most effective at treating malaria is called artemisinin: it shocks the parasite out of your system and saves your life. But in south-east Asia, horrified doctors have discovered that the malaria parasite is becoming resistant to it. In a Darwinian arms race, it has begun to evolve a way to beat the treatment. It is taking twice as long to work – and soon it will have defeated the medicine altogether.

Hari also anticipated people responding by arguing that all you had to do was spray DDT to eradicate malaria:

POSTSCRIPT: There is a hard-right myth that environmentalists “banned DDT in Africa” and “killed Africans”. It is possible some people will try to revive it in response to this article.

It is not true. There is no ban. African governments can still use DDT as much as they like. Many use it in moderation for indoor spraying. But they do not see it as a magic bullet, because it is less effective than other options, like insecticide-treated bednets, because mosquitoes have developed a significant degree of resistance to it, and because it can have dangerous side-effects, like contributing to premature births and killing off local fish populations.

Comments

  1. #1 Brian Schmidt
    August 13, 2009

    It’s important to note for stories like this that Rachel Carson and environmental groups saved thousands of lives by restricting and eliminating DDT’s use for agriculture, which reduced resistance and prolonged its usefulness as an antimalarial insecticide. If only they had been successful at restricting DDT’s use from agriculture earlier, and then still more thousands would have been saved.

  2. #2 Hank Roberts
    August 14, 2009

    I recall that a lot of the fake medicine contains small amounts of the real thing to fool simple testing.

    Doesn’t providing subclinical amounts of a medicine like this still select for resistance?

    ►Manslaughter by fake artesunate in Asia—will Africa be next
    PN Newton, R McGready, F Fernandez, MD … – PLoS Med, 2006 – medicine.plosjournals.org
    … There are now at least 12 different types of fake artesunate ……..

    A collaborative epidemiological investigation into the criminal fake artesunate trade in South …
    PN Newton, FM Fernández, A Plançon, DC … – PLoS Med, 2008 – medicine.plosjournals.org

    Counterfeit pharmaceuticals: Murder by medicine
    P Aldhous – Nature, 2005 – nature.com

  3. #3 Scott M
    August 14, 2009

    This is an obvious point, but it deserves to be made again. The people who spread the DDT myth couldn’t care less about malaria, Africa, or least of all, facts. Their goal is to discredit environmentalist. The DDT “ban” gives them a semi-plausible screed to shout out to other like minded people to re-enforce their ideological opposition to environmental stewardship. I’m not saying don’t debunk this nonsense, I’m just saying know what these people are really after and keep the arguments as simple as possible.

  4. #4 Dave Andrews
    August 20, 2009

    I have a problem with Johann Hari,

    He was very clear, quoting his links with Iraqis and such opinion polls as were able to be taken, that it was the right thing to do to invade Iraq and remove Saddam. He was unequivocal about this for several years and frequently wrote eloquently about it.

    Then when the insurgency/al Quaeda attrocities were killing lots of Iraqis ( ie, not even pretending to target the US/UK forces) he suddenly changes his mind (Perhaps because the Islington/ Stoke Newington pressure got too much.) But it was such a sudden volte face that I could never really trust anything he said again.